ArticleJournal of clinical nursing2017
Implementation evaluation and refinement of an intervention to improve blunt chest injury management-A mixed-methods study.
Article in Journal of clinical nursing, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Development and evaluation of a de-escalation training intervention in adult acute and forensic units: the EDITION systematic review and feasibility trial.Health technology assessment (Winchester, England) · 2024Pooled it
- Pooled it
- Value of a quality label and European healthcare professionals' willingness to recommend health apps: An experimental vignette study.Journal of health psychology · 2025Article
- Defining re-implementation.Implementation science communications · 2023Article
- Rapid development and implementation of a behaviour change strategy to improve COVID-19 personal protective equipment use in a regional Australian emergency department.Australasian emergency care · 2022Article
- Programmes to support transitions in community care for children with complex care needs: a scoping review.BMJ open · 2022Article
- Article
- Sustained type 1 diabetes self-management: Specifying the behaviours involved and their influences.Diabetic medicine : a journal of the British Diabetic Association · 2021Article
- Designing strategies to implement a blunt chest injury care bundle using the behaviour change wheel: a multi-site mixed methods study.BMC health services research · 2019Article
- Implementation evaluation and refinement of an intervention to improve blunt chest injury management-A mixed-methods study.Journal of clinical nursing · 2017Article
Corrections and comments
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Authors and funding
7 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
AIMS AND
objectivesTo investigate uptake of a Chest Injury Protocol (ChIP), examine factors influencing its implementation and identify interventions for promoting its use.
backgroundFailure to treat blunt chest injuries in a timely manner with sufficient analgesia, physiotherapy and respiratory support, can lead to complications such as pneumonia and respiratory failure and/or death.
designThis is a mixed-methods implementation evaluation study.
methodsTwo methods were used: (i) identification and review of the characteristics of all patients eligible for the ChIP protocol, and (ii) survey of hospital staff opinions mapped to the Theoretical Domains Framework (TDF) to identify barriers and facilitators to implementation. The characteristics and treatment received between the groups were compared using the chi-square test or Fischer's exact test for proportions, and the Mann-Whitney U-test for continuous data. Quantitative survey data were analysed using descriptive statistics. Qualitative data were coded in NVivo 10 using a coding guide based on the TDF and Behaviour Change Wheel (BCW). Identification of interventions to change target behaviours was sourced from the Behaviour Change Technique Taxonomy Version 1 in consultation with stakeholders.
resultsOnly 68.4% of eligible patients received ChIP. Fifteen facilitators and 10 barriers were identified to influence the implementation of ChIP in the clinical setting. These themes were mapped to 10 of the 14 TDF domains and corresponded with all nine intervention functions in the BCW. Seven of these intervention functions were selected to address the target behaviours and a multi-faceted relaunch of the revised protocol developed. Following re-launch, uptake increased to 91%.
conclusionsThis study demonstrated how the BCW may be used to revise and improve a clinical protocol in the ED context. RELEVANCE TO CLINICAL PRACTICE: Newly implemented clinical protocols should incorporate clinician behaviour change assessment, strategy and interventions. Enhancing the self-efficacy of emergency nurses when performing assessments has the potential to improve patient outcomes and should be included in implementation strategy.
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Registered trials
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